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Autonomic Dysreflexia, also known as Hyperreflexia, is a potentially life threatening condition which can be considered a medical emergency requiring immediate attention. It occurs where the blood pressure in a person with a spinal cord injury (SCI) above T5-6 becomes excessively high due to the over activity of the Autonomic Nervous System. The most common symptoms of autonomic dysreflexia are sweating, pounding headache, tingling sensation on the face and neck, blotchy skin around the neck and goose bumps. Not all the symptoms always appear at once, and their severity may vary. In untreated and extreme cases of autonomic dysreflexia, it can lead to a stroke and death.
There can be many stimuli that cause autonomic dysreflexia. Anything that would have been painful, uncomfortable, or physically irritating before the injury may cause autonomic dysreflexia after the injury. The most common cause seems to be overfilling of the bladder. This could be due to a blockage in the urinary drainage device, bladder infection (cystitis), inadequate bladder emptying, bladder spasms, or possibly stones in the bladder. The second most common cause is a bowel that is full of stool or gas. Any stimulus to the rectum, such as digital stimulation, can trigger a reaction, leading to autonomic dysreflexia. Other causes include skin irritations, wounds, pressure sores, burns, broken bones, pregnancy, ingrown toenails, appendicitis, and other medical complications. In general, noxious stimuli (irritants, things which would ordinarily cause pain) to areas of body below the level of spinal injury. Things to consider include: Bladder (most common) - from overstretch or irritation of bladder wall Urinary tract infection Urinary retention Blocked catheter Overfilled collection bag Non-compliance with intermittent categorisation program Bowel - over distention or irritation Constipation / impaction Distention during bowel program (digital stimulation) Hemorrhoids or anal fissures Infection or irritation (eg. appendicitis) Skin-related Disorders Any direct irritant below the level of injury (eg. - prolonged pressure by object in shoe or chair, cut, bruise, abrasion) Pressure sores (decubitus ulcer) Ingrown toenails Burns (eg. - sunburn, burns from using hot water) Tight or restrictive clothing or pressure to skin from sitting on wrinkled clothing Sexual Activity Over stimulation during sexual activity [stimuli to the pelvic region which would ordinarily be painful if sensation were present] Menstrual cramps Labor and delivery Other Heterotopic ossification ("Myositis ossificans", "Heterotopic bone") Acute abdominal conditions (gastric ulcer, colitis, peritonitis) Skeletal fractures If any of the above are found, they must be addressed in order for Autonomic Dysreflexia to be relieved.